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Navy & Marine Corps Medical News 


April 7, 2000 

The Navy Bureau of medicine and Surgery distributes Navy and 
Marine Corps Medical News (MEDNEWS) to Sailors and Marines, 
their families, civilian employees and retired Navy and Marine 
Corps families . 

MEDNEWS is a weekly compendium of news and information 
contributed by commands throughout the Navy Medical department. 
Information containing MEDNEWS stories is not necessarily 
endorsed by BUMED, nor should it be considered official Navy 

To achieve maximum medical information distribution, your 
command is highly encouraged to distribute MEDNEWS to ALL HANDS 
electronically, include MEDNEWS in command newspapers, 
newsletters and radio and TV news programs. 

Stories in MEDNEWS use these abbreviations after a Navy 
medical professional 's name to show affiliation: MC — Medical 
Corps (physician) ; DC - Dental Corps; NC - Nurse Corps; MSC - 
Medical Service Corps (clinicians, researchers and 
administrative managers) . Hospital Corpsmen (HM) and Dental 
Technician (DT) designators are placed in front of their names. 


Contents for this week's MEDNEWS: 

Headline: Video teleconferencing saves clinics funds, expands 

Headline : Air Force study suggests agent orange, diabetes link 
Headline: American Red Cross establishes Child Life Program at 

Headline: Dentist training on the table at Tokyo conference 
Headline: Health promotion emphasized at the academy (Photo) 
Headline: Focusing on health brings another award to 
Wasp (Photo) 

Headline: Anthrax question and answer 
Headline: TRICARE question and answer 

Headline: Healthwatch: Your body may be the wrong canvas for 
tattoo art (Photos) 


Headline: Video teleconferencing saves clinics funds, expands 

By Cmdr. Vernon D. Morgan and Lt. James E. Romine, U.S. Naval 
Medical Clinics United Kingdom 

LONDON - U.S. Naval Medical Clinics United Kingdom, faced 
with reduced travel funding but still needing to train Its 
medical personnel, found relief In technology by merging video 
teleconferencing Into their training plans. 
After upgrading Its video teleconferencing capabilities, 
the command experimented with monthly continuing medical 
education presentations by linking with Branch Medical Clinic 
St . Mawgan (In southwestern England) and North Audley Health 
Center (In the U.S. Naval Forces, Europe building, downtown 
London), and the command's Navy Liaison Office, Landstuhl 
Regional Medical Center, Germany. 

Success of this In house project generated Interest In 
reaching out to other military medical facilities throughout 
Europe. Because the command's video teleconferencing equipment 
Is limited to four channels, the Information 
management /Information technology department 
coordinated with Landstuhl Regional Medical Center's IM/IT 
department to host continuing medical education presentations 
across their bridging network. 

Landstuhl 's video teleconferencing Is capable of hosting 
twelve military Installations simultaneously, enabling U.S. 
Naval Medical Clinics United Kingdom to present continuing 
medical education presentations to a larger group of providers. 

The continuing medical education program by video 
teleconferencing expanded to all of Europe January 21 when Lt . 
Cmdr. Brian Smullen, MC, the command's psychiatrist, gave a 
presentation on "Oral Dependency and Abusive Behavior. " 


Headllne: Air Force study suggests agent orange, diabetes link 
By Staff Sgt . Kathleen T. Rhem, USA, American Forces Press 


WASHINGTON, — Adult-onset diabetes in Vietnam vets may be 
associated with exposure to the herbicide Agent Orange, a Air 
Force report released recently states. 

The report Is part of the long— running Ranch Hand Study 
— the Air Force Investigation Into the health risks associated 
with exposure to Agent Orange. It also Included evidence that 
herbicide exposure Is related to cardiovascular disease later In 
life. The study is called Ranch Hand because the original 
mission of spraying Agent Orange In Vietnam was called Operation 
Ranch Hand. 

"This report Includes the strongest evidence to date that 
exposure to Agent Orange is associated with adult-onset 
diabetes, " said Joel Mlchalek, a statistician with the Air Force 
Research Lab at Brooks Air Force Base, Texas. Mlchalek Is the 
principal investigator of the Ranch Hand Study. The latest 
results suggest that as dloxln levels Increase, the presence and 
severity of adult-onset diabetes Increase, he said. He also 
said that as dloxln levels increase, the time to onset of the 
disease decreases. A 47 percent Increase in diabetes was seen 
In those veterans with the highest levels of dloxln. 

"This Is particularly strong evidence since dloxln Is that 

component of Agent Orange that has been linked to many health 
effects in laboratory animals, " Michalek said. 

Michalek said the Ranch Hand veterans experienced a 26 
percent increase in heart disease, but the risk was not 
increased in those with the highest levels of dioxin. However, 
the risk of cardiovascular abnormalities , such as high blood 
pressure and the prevalence of prior heart attack indicated by 
electrocardiogram, did tend to increase with dioxin levels. 

"The mixed results mean that some indicators of disease 
increased with exposure and others did not, " he said. 
He was careful to point out that while these findings 
suggested a link between these diseases and Agent Orange 
exposure, they're not conclusive . 

"Biological processes relating herbicide exposure with 
these diseases have not yet been described, " Michalek said. 
"I'm not prepared to say that dioxin causes diabetes. People who 
have high dioxin levels are at a greater risk of diabetes. " 

The Air Force is, however, taking steps to prove cause and 
effect. The service is funding research at the University of 
California at Davis and at the Department of Veterans Affairs 
Medical Center in Little Rock, Ark., to explain any biological 
relationship between dioxin and diabetes. 

The Ranch Hand Study has been going on since 1978 and 
includes periodic examinations of about 2, 300 Vietnam veterans - 
- 1,000 who worked on Operation Ranch Hand and another 1,300 who 
flew missions in Vietnam but weren't associated with the 
operation. This latest release of information is associated 
with physical exams conducted in 1997. 

Previous examinations and reports have suggested links 
between Agent Orange exposure and nine distinct diseases: 
chloracne, Hodgkin 's disease, multiple myeloma, non—Hodgkin ' s 
lymphoma, porphyria cutanea tarda, respiratory cancers (lung, 
bronchus, larynx and trachea) , soft-tissue sarcoma, acute and 
subacute peripheral neuropathy, and prostate cancer. 

In addition, monetary benefits, health care and vocational 
rehabilitation services are provided to Vietnam veterans ' 
offspring with spina bifida, a congenital birth defect of the 
spine. VA presumes that all military personnel who served in 
Vietnam and who have one of the listed diseases were exposed to 
Agent Orange, and it compensates veterans with any of these 
diseases. Michalek said any future decisions to compensate 
veterans with diabetes would be made by the VA. 


Headline: American Red Cross establishes Child Life Program at 

By Lt . Kyra Hawn, Naval Medical Center Portsmouth 

PORTSMOUTH, Va . - The high quality care for children at 

Naval Medical Center Portsmouth, Va., has been made even better 

by addition of the Child Life Program. 

This American Red Cross project aims to meet the 
non— clinical needs of children who are admitted to NMCP. Child 
Life also seeks to address the needs of parents and family 

members who remain in the hospital with their child. 

"Child Life is the missing piece of the puzzle that can 
make or break the inpatient experience for children and their 
families, " said Sally Barclay, a Red Cross volunteer who is 
chairman of the Child Life Committee. "It encompasses all of 
the things that children need to thrive in an inpatient clinical 
environment . " 

Barclay, who lost her only child during a bone marrow 
transplant in 1991, knows first— hand the importance of a support 
network for kids and parents alike. 

"You can't make it through an experience like this alone," 
said Barclay . "Sometimes just a hot shower and time to recharge 
can change your whole outlook on things. " The Child Life Program 
offers parents time to regroup as well as outlets for counseling 
and assistance. 

The hospital 's Child Life Room is designed for computer 
activities, academic tutoring, arts and crafts, weekend movies 
and special holiday parties. Satellite rooms throughout the 
pediatrics ward offer video games, puzzles, and age appropriate 
toys. Special guest appearances are also made by cats, dogs and 
other members of NMCP's pet therapy program. 

The program is growing, but is still far from meeting its 
volunteer and donation goals. Anyone may volunteer to assist 
with the Child Life Program and become an American Red Cross 
volunteer. Specifically, the program is in search of teachers, 
tutors, story tellers, artists, clowns, jugglers, singers, 
hairdressers, and anyone capable of offering a child— specif ic 
talent or service. 

The Child Life Program wish list for equipment and toys 
includes mobiles, crib toys, educational toys, music tapes, kid 
videos, magazine subscriptions, play rugs, rocking chairs, 
Nintendo/Sega/Playstation systems and software, potty seats, 
step stools, children 's furniture, and appliances for a 'home 
away from home' room for parents. New donations are preferred, 
but gently used are also accepted. 

Donations and volunteer arrangements may be made through 
the American Red Cross Child Life Program chairman at (757) 953- 


Headline : Dentist training on the table at Tokyo conference 
By Bill Doughty, U.S. Naval Hospital Yokosuka 
YOKOSUKA, Japan — Different techniques and programs that 
will expand the scope of dental service to patients were 
exhibited in Tokyo at the 48th Annual Conference of the Tri— 
service Dental Society of Japan. 

More than 200 Navy, Army and Air Force as well as dentists 
from the Japanese community gathered in Tokyo recently for three 
days of lectures, meetings, and "table clinics. " 

Cmdr. Michael Marks, DC, conference coordinator, said 
tables with dynamic and colorful displays filled the large 
banquet room where dentists answered questions and presented 
information on cutting edge technology and clinical studies. 

Marks, a prosthodontist at U. S. Naval Dental Clinic 

Yokosuka, said that the meeting has a long tradition of 
"providing continuing education and opening lines of 
communication. " 

"Continuing education is a big focus. During activities 
like this we get to see different ideas, different techniques, 
and expand our scope of things we can deliver to the patients, " 
said Cmdr. Joel Traylor, DC, a dental surgeon from USS Kitty 
Hawk (CV 63) . 

Traylor had a popular table clinic at the conference 

enjoyed by visitors and other presenters, including LT Julie 
Fierro, DC, a general dentist from the Atsugi Branch Dental 

Fierro said, "By coming here you're learning about 
different aspects of dentistry. Not only [from] the table 
clinics, but there are also different courses and facets of 
dentistry. "There are some pediatric dentistry lectures that 
will help me when I go back, because we don't have a 
pediatric dentist in Atsugi. " 

The conference, sponsored this year by the Navy, also 
strengthened the health care network in Japan and enhanced 
personnel dental readiness of the U.S. Seventh Fleet. 


Headline: Health promotion emphasized at the academy 
By Lt. Rhoda Gabel, NC, Naval Medical Clinic Annapolis 

ANNAPOLIS, Md. — Providing health promotion information to 
midshipmen became easier in February with the opening of the 
health promotion office in Bancroft Hall. 

It is a little office doing big things bringing health 
information and material close to home for the brigade of 
midshipmen. Midshipmen now have more convenient access to 
literature, videos, displays and websites with topics of health 
promotion and personal performance that most concern a 
midshipmen or any college-age student . 

"Our new neighbor seems intent on making us healthy and 
fit", said Chief Missile Technician (SS) Donald Gemeny, Company 
Chief for 30th Company. "This is a convenient resource for the 
midshipmen and staff. " 

An avowed policy of the Department of the Navy is to 
ensure military readiness, maximize individual performance, and 
reduce the cost of military health through programs of physical 
fitness, disease prevention, and health maintenance. Health 
promotion information enables personnel to increase control over 
their health. 

Positive lifestyle and behavioral changes can improve 
health and enhance quality of life, which for the military 
translates into improved 

operational readiness and increased retention of valuable 
personnel. The Health Promotion Office will help focus the 
Naval Academy's 2010 vision in promoting lifelong physical 
fitness through education. Augmented by mental 
and character development, graduates of the Naval Academy will 
set the example for Sailors and Marines in every aspect of 


The future of the Navy begins at the Naval Academy. The 
future of military health begins here as well. The paradigm 
shift to health promotion, wellness, health leadership and 
personal performance will have the Navy and its future leaders, 
"Fit to Fight" and "Fit for Life. " 


Headline: Focusing on health brings another award to Wasp 
By J03 Kory Deur, USS Wasp (LHD 1) 

USS WASP (LHD 1) AT SEA — The Medical Department onboard 
USS Wasp (LHDl) is beginning to look like the Chicago Bulls 
during the days of Michael Jordan. 

For the third consecutive year, the Medical team has won 
the distinguished Force Commanders Annual Wellness Unit Award, 
also known as the "Green H. " The award is given to commands 
that promote and implement successful health programs for the 
betterment of the crew. 

"It 's an honor to be a part of an ongoing, successful 
health program," said Lt. Cmdr. Michael Wenzel, MC, Wasp's 
senior medical officer. 

Wenzel, from Melville, New York, and his medical 
department oversee health issues on board the Wasp, such as food 
service, injury prevention, stress management, tobacco cessation 
use and exercise . 

Nutrition education and counseling is a routine part of an 
individual's periodic health care. Complementing Wasp's 
nutrition information are healthy menus that include salads, 
fruits and vegetables. 

"The salad bar is really good, " said Seaman Marsha 
Scudella from Elmhurst, 111. "There are always fresh fruits and 
vegetables. " 

During meals, crewmembers are offered low fat options. 
Near each item is a nutrition information card detailing portion 
size, calories and fat count . 

Keeping its crew nutritionally healthy is not enough. 
Wasp safety department, with its six full— time safety personnel, 
has a comprehensive program to prevent crewmember injury. 

Add to the wellness and safety programs a stress 
management course, suicide prevention classes, smoking cessation 
training and a comprehensive picture of crew concern begins to 
emerge . 

"Navy life can be stressful, especially during 
deployment, " said Wenzel. "Helping Sailors to cope with stress 
not only allows them to perform their job but to enjoy it as 
well . " 

With the basics in place for nutrition and a healthy 
lifestyle. Wasp has also added an extensive gym to ensure 
Sailors and Marines have an opportunity to stay physically fit. 

Naval personnel achieve conditioning and strength training 
through free weights and aerobic conditioning. The ship's 
flight deck is also available, schedule permitting, for Sailors 
and Marines to use for running and calisthenics. 

"We are integrating the health risk appraisal into 
'Division in the Spotlight ' inspections and Command 
Indoctrination so that each crewmember ' s health can be 
optimized, " said Wenzel. "Likewise, the Health 

Care Promotion Committee continues to insure a safe and healthy 
working environment for safe and healthy Sailors. " 

With this type of medical and health program already in 
place. Wasp will be looking forward to winning its fourth 
consecutive Green "H", in the year 2001 . 

"We have a good chance at winning it again next year 
because it 's a team effort, not only with medical personnel but 
with support from the command as well, " said Wenzel. 


Headline: Anthrax question and answer 

Question: Has the senior leadership of the Armed Forces 
received the anthrax vaccine? 

Answer: Yes, the senior leadership, including the Secretary 
and Deputy Secretary of Defense, the Chairman of the Joint 
Chiefs, and the Service Secretaries have received anthrax 
vaccinations. Indeed, Secretary Cohen and General Shelton 
recently received their sixth doses, 18 months after their first 
doses. Many of our senior leaders have chosen to receive 
the vaccination publicly with media coverage to "lead by 
example. " However, the primary focus of the vaccination program 
is to ensure that people going to high-threat areas get first 
priority to receive the anthrax vaccine. 


Headline: TRICARE question and answer 
Question: What is the function of the Nurse Advisor? 
Answer: Nurse advisors are available in most regions, by 
phone, to provide advice and assistance that will enhance 
patient decision making about their health care. They are 
normally available 24 hours a day, 7 days a week, and can 
discuss treatment alternatives, symptoms, and illness 
prevention or can advise whether a situation warrants immediate 
medical attention. Any TRICARE— eligible person can use the 
service of the nurse advisor. 


Headline: Healthwatch: Your body may be the wrong canvas for 
tattoo art 

By JOl Maria Christina Mercado, Naval Hospital Pensacola 

PENSACOLA, Fla. — If the Navy wanted you to have a tattoo, 
they would have issued it with your sea bag. 

Tattoos. They certainly weren't issued with your sea bag, 
but some of your shipmates probably have made that trek off base 
to a 'parlor' at least once in their lives. 

Some young Sailors, Airmen, Soldiers or Marines see a 
visit to the tattoo parlor as a rite of passage. For many, a 
tattoo emblazoned upon their flesh is a lasting reminder of the 
camaraderie once shared. 

However, before you exit the main gate, keep in mind there 
are health and professional issues you may want to be aware of 
before deciding whether a tattoo is right for you. 

"The two most significant risks [associated with tattoos] 
are allergic responses to the pigments and exposure to blood- 
borne pathogens, " said Cmdr. Alan Rolfe, MSC, head of Naval 
Hospital Pensacola's dermatology department. 

"After the initial inflammatory reaction to the trauma of 
pricking the skin hundreds of times to place the tattoo pigments 
and dyes, other reactions can occur. Allergic reactions and 
foreign-body reactions to some of the pigments and dyes are not 
uncommon, " said Rolfe. 

"The sudden onset of swelling, irritation and redness in 
portions of the tattoo can occur weeks or years after its 
placement . Significant infection of tattoos is now unusual, but 
poor infection control by the tattoo artist and the [recipient] 
can lead to a risk of serious bacterial or viral infection, " 
said Rolfe. 

But along with that bad news is some good news for those 
seeking tattoos. They can be applied safely when you know how 
to select a tattoo artist . 

"Make sure the tattoo artist is established, " warns 
Aviation Boatswain ' s Mate Airman Recruit Jason Ankney, a student 
assigned to the Naval Air Technical Training Center (NATTC) in 
Pensacola. The Miami native has five tattoos and he wants to 
have one removed. 

"A scratcher is someone who works out of the kitchen or a 
van. He's someone who should definitely be avoided, " said Chief 
Hospital Corpsman David C. Pearce, a 6— time tattoo recipient and 
head of the preventive medicine department at Branch Medical 
Clinic, Naval Air Station, Pensacola. 

Legitimate tattoo artists follow proper infection control 
procedures and would never risk their reputation by failing to 
follow appropriate health measures, according to Pearce. 

The Centers for Disease Control and Prevention in Atlanta 
reports the transmission risk of HIV and Hepatitis B or C exists 
if instruments contaminated with blood are either not sterilized 
or properly disinfected or are used inappropriately between 
clients. CDC recommends that instruments intended to penetrate 
the skin should be used only once, then disposed of or 
thoroughly cleaned and sterilized. 

If you 're considering a tattoo or having your body 
pierced, ask the establishment 's staff what procedures they use 
to prevent the spread of HIV and other blood— borne infections, 
such as Hepatitis B or C. 

"If they can't answer those questions or offer 
unsatisfactory answers, just walk away, " said Pearce. "A 
legitimate tattoo artist will have no trouble answering your 
questions because his livelihood depends on doing a good job and 
maintaining his reputation, " said Pearce. 

"I just wanted to get a tattoo, " said Hospital Corpsman 3rd 
Class Marvin Celestino. "I went out with all my friends and we 
did it, " he said. 

"I looked around and saw that the man was using packaged 

sterile needles. I wouldn't have done it if I wasn't convinced 
his shop was clean," the Manasses, Va., native said. 

Even after you consider the health issues, consider also 
the professional implications before you get that tattoo. 

"An inappropriate tattoo can disqualify a Sailor for 
certain types of duty, such as recruiting, " said Master Chief 
Journalist Randy Kafka, command master chief of Naval Hospital 
Pensacola . 

There are more than a few instances of young service 
members getting tattoos, which they later regretted, said Kafka 
who has even gone with friends to tattoo parlors, but decided 
not to get one because it was permanent . 

"There is nothing I need to have permanently tattooed on 
my body, " he said. 

Hospital Corpsman and Atlanta native April Few, who works 
at Naval Hospital Pensacola got a butterfly on her second trip 
to the tattoo parlor. "I really wanted a butterfly . No one has 
ever said anything bad about [the tattoo] , but sometimes I still 
wonder if it looks all right when I 'm wearing my uniform, " she 

Sailors with offensive or inappropriate tattoos have been 
ordered to wear long sleeves to hide the tattoos, the command 
master chief added. "Anybody thinking about getting a tattoo 
must really consider the ramifications tomorrow and 20 years 
from now because a tattoo is forever, " said Kafka. 

"The wearing or displaying of clothing, jewelry or tattoos 
. . . depicting marijuana or any other controlled substance or 
advocating drug abuse is prohibited at all times on any military 
installation or under any circumstances, which is likely to 
discredit the Navy, " said Master Chief Boatswain's Mate B.C. 
Cruse of the Navy Uniform Matters Office. 

There is no other "official policy" regarding tattoos. 

"Military personnel with unprofessional tattoos on the 
legs, ankles, or arms can be directed by their commanding 
officer to permanently wear long sleeve shirts" or women may be 
required to only wear slacks to cover the tattoo, " said Cruse. 

"I've heard of young Marines coming to the hospital hoping 
to have a tattoo removed because they're putting in for an 
officer program. We tell them sorry, " said Kafka, "under normal 
situations the Navy does not remove tattoos. " 

"Think about it before you do it, " said Celestino, 
"because once you do it, it can be expensive — and painful — 
to take back. " 


Comments about and ideas for MEDNEWS are welcome . Story 
submissions are encouraged. Contact MEDNEWS editor. Earl W. 
Hicks, at email:; Telephone 202/762— 
3223, (DSN) 762-3223, or fax 202/762-3224.